endocrine

Question 1

3 criteria of DKA

Answer 1

ketones >3
glucose >11
bicarbonate <15

Question 2

treatment of DKA

Answer 2

potassium
fluids
insulin

Question 3

investigation for DKA

Answer 3

GGT

decreased C peptides (specific for type 1, not decreased in type 2)

Question 4

antibodies in type 1 diabetes

Answer 4

anti GAD
islet cell antibodies (destroy beta cells of islets of langerhan)

Question 5

HbA1c levels

Answer 5

≤41 normal
42-47 pre-diabetes
≥48 diabets
<53 goal for diabetics

Question 6

type 2 diabetes + CVD

Answer 6

metformin + sulphonurea

Question 7

insulin in ramadan

Answer 7

1/3 before sunrise
2/3 after sunset

Question 8

treatment of diabetic peripheral neuropathy

Answer 8

amitryptilin
duloxentine
gabapentin
pregabilin

Question 9

MODY inheritance pattern

Answer 9

autosomal dominant

Question 10

cause of cranial DI

Answer 10

decreased production of ADH - heamocromatosis

Question 11

cause of nephrogenic DI

Answer 11

desensitisation of ADH - lithium

Question 12

treatment of DI

Answer 12

cranial = desmopressin
nephrogenic - thiazides, low salt

Question 13

treatment of SIADH

Answer 13

fluid restriction

Question 14

type 1 diabetes + BMI >25

Answer 14

insulin + metformin treatment

Question 15

when should type 1s measure glucose

Answer 15

before each meal and before bed

Question 16

blood inbalance in cushings

Answer 16

hypokalaemia

metabolic alkalosis

Question 17

high dose dexamethasone test results

Answer 17

cortisol & ACTH

both decreased - cushings disease
both increase - steroids
1 increases (cortisol) 1 decreases - something else

Question 18

pseudo-cushings

Answer 18

alcohol excess

Question 19

blood results in SIADH

Answer 19

decreased blood sodium
increased urine sodium

diluted blood - concentrated pee

Question 20

treatment of MODY

Answer 20

sulphonureas

Question 21

posterior pituitary hormones

Answer 21

ADH & oxytocin

Question 22

treatment of prolactinoma

Answer 22

dopamine agonists

cabergoline
bromocriptine

Question 23

investigation into acromegaly

Answer 23

serum IGF - 1

Question 24

treatment of acromegaly

Answer 24

surgery

octreotide/ pegrisomant

Question 25

what is addisons

Answer 25

decreased adrenal function

decreased mineralocorticoids (aldosterone), androgens & glucocorticoids (cortisol)

Question 26

investigation into Addison’s

Answer 26

short synACTHen test
or 9am cortisol

Question 27

treatment of addisons

Answer 27

cortisol replacement - hydrocortisone
aldosterone replacement - fludrocortisone

Question 28

what happens in an addisons crisis

Answer 28

pt stops taking hysrocortisone - cortisol plummets

Question 29

periods and thyroid

Answer 29

hypothyroid - no periods (amenorrhea)
hyper - heavy periods

Question 30

cause of follicular thyroid cancer

Answer 30

low iron

Question 31

hyperparathyroid
primary vs secondary vs tertiary

Answer 31

primary (tumour) - increased Ca, low phosphate

secondary (decreased Vit D) - low Ca, high phosphate

tertiary (long secondary) - very high PTH, high Ca

Question 32

blood results in hyperaldosteronism

Answer 32

low potassium
high sodium (high BP)

Question 33

treatment of bilateral adrenal hyperplasia (hyperaldosterone)

Answer 33

spirinolactone

Question 34

MEN 1

Answer 34

parathyroid (hyper)
pancreas
pituitary

Question 35

MEN 2a

Answer 35

(RET oncogene)
parathyroid (hyper)
phaechromocytoma
medullary thyroid cancer

Question 36

MEN 2b

Answer 36

(RET oncogene)
phaechromocytoma
medullary thyroid cancer
marfanious

Question 37

radioiodine & graves disease

Answer 37

makes eye problems worse

Question 38

C peptide in T1DM

Answer 38

low

Question 39

when to treat subclinical hypothyroid

Answer 39

+ve result twice in 3 weeks

Question 40

treatment of thyroid storm

Answer 40

beta blockers
propylthiouracil
hydrocortisone